The risk provided for by the insurance contract has come true. This is the circumstance that triggers the application of the guarantees provided for in the contract. In particular, the insurer may refuse compensation on account of the late declaration of the claim.
Article L. 113-2 of the Insurance Code provides that the insured has the obligation to notify the insurer, as soon as he has become aware of it and at the latest within the period fixed by the contract, of any claim likely to result in the insurer’s guarantee. The same article adds that this period may not be less than five working days.
Article L. 113-2 of the Insurance Code makes the implementation of the forfeiture conditional on the delay having caused harm to the insurer.
The insurer’s assessment of the existence of the injury and its alleged quantum is the sovereign assessment of the courts.
it should be remembered that a forfeiture clause will only be valid if it appears in the insurance policy in very apparent characters, and this, in accordance with the drafting requirements imposed by article L. 112-4 of the Insurance Code.
Finally, a forfeiture clause must be unambiguous, that is, it must be clear, special and precise, in that it knows under what conditions exactly it will not be guaranteed. Otherwise, it may be declared unenforceable against the insured by the court, i.e. unenforceable.
Let us recall, on the latter point, that the insurance contract is interpreted against the drafter, who is most often the insurer. Against the drafter of act means in the sense of applicability of insurance coverage.